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Related Experiment Video

Updated: Mar 1, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Biventricular Impella placement via complete venous access.

Norihiko Kamioka1, Ateet Patel1, Michael A Burke1

  • 1Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|May 26, 2017
PubMed
Summary

Impella support for refractory cardiogenic shock can be achieved via venous and caval-aortic access, even with inadequate peripheral arterial access. This less invasive technique offers a vital bridge to advanced therapies like ventricular assist devices or heart transplantation.

Keywords:
Impellacardiogenicfistula-shuntsheart failuremechanical circulatory supportshock

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Devices

Background:

  • Critical refractory cardiogenic shock necessitates emergent treatment.
  • Impella devices offer left ventricular support but may require surgical access in patients with inadequate peripheral arterial access.
  • Impella is also utilized for right ventricular support in biventricular dysfunction.

Observation:

  • A case of refractory cardiogenic shock in a patient with inadequate vascular access was reported.
  • The patient received biventricular Impella support.
  • Access was achieved via venous and caval-aortic routes under conscious sedation.

Findings:

  • Biventricular Impella support was successfully implemented using a novel venous and caval-aortic access technique.
  • This approach circumvented the need for surgical access in a patient with challenging vascular anatomy.
  • The procedure was performed under conscious sedation, minimizing invasiveness.

Implications:

  • This technique provides an alternative for emergent Impella placement in patients with inadequate peripheral arterial access.
  • It offers a less invasive option for managing complex cardiogenic shock.
  • This method serves as a potential bridge to durable mechanical circulatory support or heart transplantation.